BRENTWOOD, Tenn.--(BUSINESS WIRE)--March 04, 2026--
Ardent Health, Inc. $(ARDT)$ ("Ardent Health" or the "Company"), a leading provider of healthcare in growing mid-sized urban communities across the U.S., today announced results for the quarter ended December 31, 2025.
Fourth Quarter 2025 Operating and Financial Summary
All comparisons are versus the same prior year period. See the footnotes to the Operating Statistics table of this press release for definitions of the metrics below and a full list of key operating metrics.
Total Revenue Net Income Attributable to Ardent
4Q25: $1.61 billion Health 4Q25: $45 million
2025: $6.32 billion; 6.0% growth Y/Y
------------------------------------- ---------------------------------------
Adjusted EBITDA(1) Adjusted EBITDAR(1)
4Q25: $134 million 4Q25: $176 million
2025: $545 million; 9.3% growth Y/Y
------------------------------------- ---------------------------------------
Admissions Adjusted Admissions
4Q25: 1.5% growth Y/Y 4Q25: 2.0% growth Y/Y
------------------------------------- ---------------------------------------
Operating Cash Flow Issuing Full-Year 2026 Guidance Total
4Q25: $223 million Revenue: $6,400 - $6,700 million
87% growth Y/Y Adjusted EBITDA(1) : $485 - $535
million
------------------------------------- ---------------------------------------
(1) Adjusted EBITDA and Adjusted EBITDAR are financial measures that have
not been prepared in a manner that complies with U.S. generally accepted
accounting principles ("GAAP"). See "Supplemental Non-GAAP Financial
Information" and reconciliations of non-GAAP measures to their most
comparable GAAP financial measures contained later in this press
release.
Solid Finish to 2025: IMPACT Program Building Momentum; Robust Cash Flow
Generation "I'm pleased with tangible progress from the deliberate, measurable
actions we took during the fourth quarter to mitigate the payor denial and
professional fee industry pressures we outlined on the third quarter earnings
call," stated Marty Bonick, President and Chief Executive Officer of Ardent
Health. "Disciplined execution and expense optimization drove solid fourth
quarter adjusted EBITDA results. Our IMPACT program is building traction and
resulted in significant SWB expense improvements, particularly in contract
labor. Additionally, I'm encouraged by payor denial and professional fee
dynamics that were stable in the fourth quarter." "The solid finish to the
year resulted in 2025 revenue and adjusted EBITDA growth of 6% and 9%,
respectively, with adjusted EBITDA margins expanding 20 basis points," added
Bonick. "Furthermore, we generated robust operating cash flow of $471 million
in 2025, up nearly 50%. We also strengthened our balance sheet by improving
net leverage to 2.5x and growing cash to over $700 million at year-end." "We
enter 2026 with improving momentum from our IMPACT program, which we now
expect to generate $55 million of savings this year, up from $40 million
previously. We are highly focused on optimizing revenue, disciplined expense
management, and productivity, all while delivering superior quality,"
continued Bonick. "At the same time, we are stepping over annualization of the
aforementioned industry headwinds and the expiration of enhanced Exchange
subsidies. As such, we are taking a prudent approach to establishing our 2026
adjusted EBITDA guidance of $485-$535 million." "We remain confident in our
ability to deliver long-term shareholder value," stated Bonick. "We expect to
return to adjusted EBITDA growth in 2027, and over the longer-term our
business is strategically well-positioned to leverage key pillars including:
durable demand, operational efficiencies captured by our IMPACT program, and
capital deployment supported by our strong balance sheet."
------------------------------------------------------------------------------
Financial Performance Summary
Fourth quarter 2025 year-over-year growth rates were negatively impacted by the Company recording two quarters of financial benefit from the New Mexico state directed payment program in the prior year quarter.
For the fourth quarter of 2025:
-- Total revenue decreased 0.1% year-over-year to $1,605 million, driven
primarily by a 2.0% increase in adjusted admissions offset by a 2.4%
decrease in net patient service revenue per adjusted admission. Total
revenue increased approximately 3% year-over-year when adjusting for the
New Mexico state directed payment program that included two quarters of
financial benefit in the prior year quarter.
-- Net income attributable to Ardent Health was $45 million, or $0.32 per
diluted share, compared to net income attributable to Ardent Health of
$114 million, or $0.81 per diluted share, in the fourth quarter of 2024.
-- Adjusted EBITDA decreased 26.6% year-over-year to $134 million.
For the full-year 2025, revenue increased 6.0% to $6.32 billion, Adjusted EBITDA grew 9.3% to $545 million, and Adjusted EBITDA margin expanded 20bps to 8.6%.
Operating Performance Summary
The following table provides a summary of certain key operating metrics for the fourth quarter of 2025 compared to the same prior year period. See the footnotes to the Operating Statistics table of this press release for definitions of the metrics below and a full list of key operating metrics.
Three Months Ended December 31,
------------------------------------------
(Unaudited) 2025 2024 % Change
-------------- -------------- ----------
Adjusted admissions 88,583 86,872 2.0%
Admissions 40,896 40,300 1.5%
Inpatient surgeries 9,466 9,108 3.9%
Outpatient surgeries 23,976 24,296 (1.3%)
Total surgeries 33,442 33,404 0.1%
Emergency room visits 158,256 161,010 (1.7%)
Net patient service revenue
per adjusted admission $ 17,757 $ 18,200 (2.4%)
-- Admissions for the fourth quarter of 2025 increased 1.5% year-over-year,
driven by strong inpatient surgery growth.
-- Surgeries for the fourth quarter of 2025 increased 0.1% year-over-year.
The increase in total surgeries reflected inpatient surgery growth of
3.9% largely offset by a decrease in outpatient surgeries of 1.3%.
Balance Sheet, Cash Flow & Liquidity Update
As of December 31, 2025, the Company had total cash and cash equivalents of $710 million and total debt of $1.1 billion. The Company's net leverage ratio as of December 31, 2025, was 0.8x, as calculated under the Company's credit agreements, and its lease-adjusted net leverage ratio(1) was 2.5x, an improvement from 2.9x as of December 31, 2024. At the end of the fourth quarter, the Company's available liquidity was $1 billion.
During the fourth quarter of 2025, net cash provided by operating activities was $223 million, compared to $120 million in the same prior year period. For the full-year 2025, net cash provided by operating activities increased 49% to $471 million.
During the fourth quarter of 2025, the Company repurchased 0.35 million shares of its common stock for $3 million. The Company had $47 million remaining under its repurchase authorization as of December 31, 2025.
____________________
(1) Lease-adjusted net leverage ratio is defined as the Company's net debt
as of December 31, 2025, plus 8x trailing twelve-month real estate
investment trust ("REIT") rent expense as of the end of the fourth
quarter of 2025, divided by trailing twelve-month Adjusted EBITDAR as of
December 31, 2025.
Introducing 2026 Financial Guidance
The Company is providing initial full-year 2026 financial guidance. The guidance incorporates a number of assumptions, including headwinds from annualization of elevated professional fees and other rate pressures driven by payor denials, Exchange disruption, and restoration of short-term compensation. The outlook also assumes tailwinds from mid-single digit core earnings growth and IMPACT program savings. All guidance is current as of the time provided and is subject to change.
(Unaudited; dollars in millions, except per share
amount) Full Year 2026 Guidance
---------------------------
Total revenue $6,400 -- $6,700
Net income attributable to Ardent Health, Inc. $129 -- $183
Adjusted EBITDA $485 -- $535
Rent expense payable to REITs $168 -- $168
Diluted earnings per share $0.90 -- $1.27
Adjusted admissions growth 1.5% -- 2.5%
Capital expenditures $225 -- $265
(MORE TO FOLLOW) Dow Jones Newswires
March 04, 2026 16:15 ET (21:15 GMT)